ArticleBMJ (Clinical research ed.)2006
Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study.
Article in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01359033 (Compare the Patient Risk and Between-hospital Variation in Myocardial Infarction Mortality in the United Kingdom and Sweden), which is not on this map. Cited by 20 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Compare the Patient Risk and Between-hospital Variation in Myocardial Infarction Mortality in the United Kingdom and Sweden
Who cites it
20 citing papers in PubMed, 77 citations in OpenAlex.
- Assessing Supply, Demand, and Adequacy of Cardiologists in the United States: Projecting a National Shortage.Journal of the American Heart Association · 2026Article
- Association between care by hypertension specialists and major adverse cardiovascular events in patients with uncontrolled hypertension.Frontiers in cardiovascular medicine · 2026Article
- Impact of Admission Ward on Long-Term Outcomes in Patients with Non-ST Elevation Myocardial Infarction.Journal of clinical medicine · 2025Article
- 'Who does this patient belong to?' boundary work and the re/making of (NSTEMI) heart attack patients.Sociology of health & illness · 2018Article
- Geographic variation in the treatment of non-ST-segment myocardial infarction in the English National Health Service: a cohort study.BMJ open · 2016Article
- Optimal medical therapy for secondary prevention after an acute coronary syndrome: 18-month follow-up results at a tertiary teaching hospital in South Korea.Therapeutics and clinical risk management · 2016Article
- Article
- Inequalities in care in patients with acute myocardial infarction.World journal of cardiology · 2015Review
- Impact of cardiology referral: clinical outcomes and factors associated with physicians' adherence to recommendations.Clinics (Sao Paulo, Brazil) · 2014Article
- Provider specialty and atrial fibrillation treatment strategies in United States community practice: findings from the ORBIT-AF registry.Journal of the American Heart Association · 2013Observational
- Long-term exposure to air pollution is associated with survival following acute coronary syndrome.European heart journal · 2013Article
- Regional density of cardiologists and rates of mortality for acute myocardial infarction and heart failure.Circulation. Cardiovascular quality and outcomes · 2013Observational
- Primary coronary intervention versus thrombolytic therapy in myocardial infarction patients in the Middle East.International journal of clinical pharmacy · 2012Article
- Acute coronary syndromes: an old age problem.Journal of geriatric cardiology : JGC · 2012Article
- Quality of acute coronary care in emerging economies.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2009Article
- Data sources and performance measurement.BMJ (Clinical research ed.) · 2007Article
- Effects of comorbidity and hospital care on 6-month mortality in patients with elevated cardiac troponin T.Postgraduate medical journal · 2007Article
- Acute coronary syndrome.BMJ (Clinical research ed.) · 2007Article
- Article
- Protective vascular treatment of patients with peripheral arterial disease: guideline adherence according to year, age and gender.Canadian journal of public health = Revue canadienne de sante publiqueArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine process of care and outcome for patients admitted with acute myocardial infarction to hospitals in England and Wales in relation to type of consultant care and type of hospital.
designObservational study of 88,782 patients admitted with myocardial infarction during 2004-5, using records from the national audit of myocardial infarction project (MINAP) database. OUTCOME MEASURES: Use of reperfusion treatment and secondary prevention drugs, use of angiography, and 90 day mortality of patients admitted under the care of cardiologists and non-cardiologists in hospitals with and without facilities for coronary intervention.
findings36% of patients were admitted under the care of a cardiologist and 20% to a hospital with coronary interventional facilities. Patients admitted under cardiologists had fewer comorbidities than other patients and were more likely to have reperfusion treatment (12,266/14,433 (85%) v 13,682/17,064 (80%)) and appropriate secondary prevention drugs. Overall, 27,431/79,374 (35%) of patients had angiography. Relatively more patients admitted to interventional hospitals (8167/14,661; 56%) than to other hospitals had angiography (19,264/64,713; 30%). The adjusted risk of death by 90 days for patients treated in interventional compared with non-interventional hospitals was 0.93 (95% confidence interval 0.82 to 1.06). The adjusted risk of death at 90 days for patients admitted under cardiologists compared with non-cardiologists was 0.86 (0.81 to 0.91).
conclusionsPatients cared for by cardiologists had less comorbidity than other patients. They were more likely to receive proved treatments and angiography, and they had a lower adjusted 90 day mortality. Large differences existed in the use of angiography between interventional and non-interventional hospitals. These findings show wide variations in the management and outcome of patients with myocardial infarction in England and Wales.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.